Current Medical Mycology http://cmm.mazums.ac.ir
Current Medical Mycology - Journal articles for year 2016, Volume 2, Number 3Yektaweb Collection - http://www.yektaweb.comen2016/9/11Use of cost effective and rapid molecular tools for identification of Candida species,
opportunistic pathogenshttp://cmm.mazums.ac.ir/browse.php?a_id=109&sid=1&slc_lang=en
<p><strong>Background and Purpose<span dir="RTL"> :</span></strong>Candidiasis is a widespread fungal infection caused by different <em>Candida</em> species<span dir="RTL">.</span> Rapid identification of <em>Candida</em> species in clinical laboratory is becoming increasingly important since the identification and discrimination of ethological agents for early treatment. We aimed at molecular identification of commonly <em>Candida</em> species isolated from clinical samples by using both PCR<span dir="RTL">-</span>RFLP assay and amplification of hwp1 gene.</p>
<p><strong>Materials and Methods: </strong>Clinical samples comprising of vaginal specimens<span dir="RTL"> ,</span>cutaneous<span dir="RTL">,</span> sputum, bronchoalveolar lavage<br clear="all" >
(BAL<span dir="RTL">,(</span> and blood cultures were recovered from suspected patients<span dir="RTL">.</span><em> Candida</em> isolates were initially identified<br clear="all" >
phenotypically and confirmed by molecular approaches based on restriction fragment length polymorphism (PCR<span dir="RTL">-</span>RFLP <span dir="RTL">(</span>with <em>MspI </em>restriction enzyme<span dir="RTL">.</span> Amplification of hwp1 gene was performed for discrimination of <em>C. albicans</em> from <em>C. dubliniensis</em> and <em>C. africana</em>.</p>
<p><strong>Results</strong>: The most abundant species were <em>C. albicans </em>(n=67; 44.6 %), <em>C. glabrata</em> (n=10; 20 %), <em>C<span dir="RTL">.</span> tropicalis</em><br clear="all" >
(n=20; 13.3 %), <em>C. krusei </em>(n=12; 8 %),<em> C<span dir="RTL">.</span> parapsilosis</em> (n=11; 7.3 %). Out of 67 <em>C<span dir="RTL">.</span> albicans</em> species, 6 species identified as <em>C. dubliniensis </em>and 4 species identified as <em>C. africana</em><span dir="RTL">. </span></p>
<p><strong>Conclusion: </strong>High frequency of non<span dir="RTL">-</span><em>albicans Candida </em>species and differences in levels of susceptibility to the antifungal agents are important issues in medicine<span dir="RTL"> .</span>Therefore, to manage the <em>Candida</em><span dir="RTL">-</span>related infections properly, molecular diagnostic methods would be fast, reliable and even cost<span dir="RTL">-</span>effective approaches for identification of <em>Candida</em> species<span dir="RTL">.</span></p>
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Azar SabokbarAeromycological analysis of allergenic airborne fungi in Qazvin, Iranhttp://cmm.mazums.ac.ir/browse.php?a_id=111&sid=1&slc_lang=en
<p><strong>Background and Purpose:</strong> Airborne fungi are one of the most important agents responsible for triggering allergic<br clear="all" >
reactions such as rhinitis and severe asthma. This study was conducted to analyze and monitor the prevalence and distribution patterns of atmospheric fungal aerosols in the air of Qazvin during winter of 2012<span dir="RTL">.</span></p>
<p><strong>Materials and Methods: </strong>In the current descriptive study, the incidence and diversity of potentially allergenic airborne<br clear="all" >
fungi were determined using two times sampling interval in 25 different locations of Qazvin city by Petri dish trapping<br clear="all" >
technique and exposure of 10- cm diameter plates of Sabouraud<span dir="RTL">&rsquo;</span>s dextrose agar medium plus chloramphenicol to the air<span dir="RTL">.</span><br clear="all" >
<strong>Results:</strong> A total of 2867 fungal colonies were counted on 156 Petri dishes. Of the identified 18 microfungi genera,<br clear="all" >
<em>Cladosporium</em> spp. was the most frequently isolated genera representing 30.9% of isolates, followed by 30.9% Penicillium spp. (27.3%), Aspergillus spp %) . (24.5 , Alternaria spp. (3.3%), Rhizopus spp. (3.1%), and other fungal genera.</p>
<p><strong>Conclusion:</strong> The high prevalence, high quantity and variety of allergenic airborne fungi in the air of Qazvin showed<br clear="all" >
that people residing in this area are exposed to health hazards. Furthermore, reduction of exposure to bio<span dir="RTL">-</span>aerosols<br clear="all" >
containing these outdoor fungi is necessary to improve the health of individuals, especially those sensitive to<br clear="all" >
fungal<span dir="RTL">-</span>induced diseases like asthma<span dir="RTL">.</span></p>
Seyed Amir GhiasianCharacterization and identification of candiduria due to Candida species in
diabetic patientshttp://cmm.mazums.ac.ir/browse.php?a_id=112&sid=1&slc_lang=en
<p><strong>Background and Purpose: </strong>The presence of <em>Candida </em>yeasts in urine, known as candiduria, is an indicator of infection or colonization of the urinary tract by <em>Candida</em> species. This condition in diabetic patients can be hazardous due to diminished immune system response. The objective of this study was to investigate the incidence of candiduria in diabetic patients and to identify its causative agents. Furthermore, the demographic and laboratory (HbA<sub>1c</sub>, urine glucose and pH, urine culture colony count, and fasting blood sugar) data and their possible associations with candiduria were investigated.</p>
<p><strong>Materials and Methods: </strong>This cross<span dir="RTL">-</span>sectional, descriptive study was performed on 305 diabetic patients referred to<br clear="all" >
the diabetes research center, Hamedan, Iran, during April 2015 to September 2015. Urine and blood specimens were<br clear="all" >
collected and urine analysis, urine culture, FBS, and HbA<sub><span dir="RTL">1</span>c</sub> tests were performed. Positive cases were subjected to<br clear="all" >
colony count and the causative agents were subsequently identified through the routine identification tests, as well as<br clear="all" >
colony color in CHROMagar Candida medium, and the assimilation patterns in API 20 C auxanographic method<span dir="RTL">.</span></p>
<p><strong>Results: </strong>Among the 305 cases, 38 (%12.5) were positive for candiduria. Causative agents were identified as<br clear="all" >
<em>Candida glabrata</em> (n=19, 50%),<em> C. albicans </em>(n=12, 31.6%), <em>C. krusei</em> (n=4, 10.5%),<em> C. tropicalis</em> (n=2, 5.3%), and<br clear="all" >
<em>C. kefyr</em> (n=1, 2.6%). According to the results of the statistical analyses<span dir="RTL">, </span>there were significant association between<br clear="all" >
candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c &ge;8), and acidic urine pH (<em>P</em><0.05)<strong>.</strong></p>
<p><strong>Conclusion: </strong>Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted<span dir="RTL">.</span></p>
Reza AslaniIs human dectin-1 Y238X gene polymorphism related to susceptibility to recurrent
vulvovaginal candidiasis?http://cmm.mazums.ac.ir/browse.php?a_id=119&sid=1&slc_lang=en
<p><strong>Background and Purpose:</strong> Vulvovaginal candidiasis is a frequent disease affecting approximately more than %75 of all childbearing women at least once in their lifetime by overgrowth of opportunistic Candida species. Recurrent vulvovaginal candidiasis (RVVC) is common in otherwise healthy individuals. Several risk factors were reported to contribute to RVVC susceptibility. A polymorphism in Dectin-1 (Y238X, rs16910526 ) was identified in patients with RVVC and hypothesized that genetic factors play an important role in susceptibility to RVVC. Herein, we aimed to survey the polymorphisms in the Dectin-1 gene, linked to susceptibility to RVVC<span dir="RTL">.</span></p>
<p><strong>Materials and Methods:</strong> In the current study, blood samples were obtained from 25 patients who had frequent vulvovaginal candidiasis relapses and were diagnosed as RVVC. In addition, blood cultures were obtained from control group comprising of healthy individuals (n=25) with no history of RVVC, vaginal discharge, or itching on the day of examination. Dectin-1 Y238X gene polymorphism was investigated using Bi-PASA and DNA sequencing<span dir="RTL">.</span></p>
<p><strong>Results:</strong> The analysis revealed that all of the patients were wild-type homozygous for Dectin-1 Y238X polymorphisms. None of the individuals showed heterozygous or mutant homozygous Dectin-1 polymorphism<span dir="RTL">.</span></p>
<p><strong>Conclusion:</strong> No significant correlations were observed between the susceptibility to RVVC and Dectin-1 Y238X polymorphism in the Iranian population, which was not previously studied.</p>
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Hamid BadaliCandidemia in patients with prolonged fever in Kashan, Iranhttp://cmm.mazums.ac.ir/browse.php?a_id=106&sid=1&slc_lang=en
<p><strong>Background and Purpose:</strong> <em>Candida</em> species are considered a common cause of fungal blood stream infections, which are associated with considerable mortality and morbidity rates, especially in the admitted and immunocompromised patients. Despite the increase in new and available antifungal agents, the emergence of resistant strains is growing. Regarding this, the aim of the present study was to assess the fungal epide<span dir="RTL">&shy;</span>miology of candidemia and the antifungal susceptibility patterns against five current antifungal agents among the patients with prolonged fever, who were admitted to Beheshti Educational Hospital, Kashan, Iran<span dir="RTL">.</span></p>
<p><strong>Materials and Methods: </strong>This cross<span dir="RTL">-</span>sectional study was conducted on 253 hospitalized patients with prolonged fever despite receiving broad<span dir="RTL">-</span>spectrum antibiotic therapy. Blood samples were collected aseptically<span dir="RTL">, </span>and then cultured using an automated blood culture system and conventional broth culture bottle. <em>Candida</em> isolates were identified at species level using morphological and physiological properties and produced color on the CHROMagar Candida. Furthermore, the antifungal susceptibility testing was performed using<span dir="RTL"> (</span>CLSI M27<span dir="RTL">-</span>A3 and CLSI M27<span dir="RTL">-</span>S4<span dir="RTL">) </span>broth microdilution methods<span dir="RTL">.</span></p>
<p><strong>Results: </strong>The most positive cultures were detected by the automated blood culture system. <em>C.</em> <em>albicans</em> (%50) was the most prevalent species, followed by <em>C. glabrata</em> (%40), and <em>C. parapsilosis</em>, (%10)&nbsp; respectively .The mortality rate was high (%60) and most patients with candidemia were admitted to the Intensive Care Unit and Neonatal Intensive Care Unit. All isolates were susceptible to amphotericin B, while the highest resistance belonged to caspofungin.</p>
<p><strong>Conclusion:</strong> In this study, high resistance was reported, especially for caspofungin, which can be regarded as the emergence of caspofungin<span dir="RTL">-</span>resistant strains. Regarding this, the establishment of a surveillance and prevention program for the reduction of the emergence of resistant species is necessary.</p>
Mehdi NazeriA seasonal study for determination of aflatoxin M1 level in dairy products in
Iranshahr, Iranhttp://cmm.mazums.ac.ir/browse.php?a_id=120&sid=1&slc_lang=en
<p><strong>Background and Purpose<span dir="RTL"> :</span></strong>Aflatoxin M1, in milk and dairy products, is classified by the International Agency for Research on Cancer as human carcinogens (class 2B). The aim of this study was to evaluate aflatoxin M1 contamination level in dairy products from Iranshahr city, Iran, using ELISA technique<span dir="RTL">. </span></p>
<p><strong>Materials and Methods: </strong>In our study, 87 samples of milk, white cheese, yoghurt, and butter were collected in different seasons and after preparation, were analyzed by ELISA technique<span dir="RTL">.</span></p>
<p><strong>Results: </strong>The contamination level of aflatoxin M1 in pasteurized milk (n=40) yoghurt (n=15), white cheese (n=6), and butter (n=10) samples were determined to be 81.6%, 83.3%, 60%, and 100%, respectively. However, in 8.1% of the pasteurized milk samples, aflatoxin M1 concentration was above the legal accepted limit (>50 ng)<span dir="RTL">.</span> The level of aflatoxin M1 was significantly higher in winter compared to summer (<em>P<0.05</em>). In addition, the concentration of aflatoxin M1 was higher in urban regions than rural ones (<em>P<0.05</em>).</p>
<p><strong>Conclusion: </strong>The results of this study emphasized the importance of seasonal and regional effects on aflatoxin M1 contamination of dairy products.</p>
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Nooshin SohrabiEpidemiological survey of dermatophytosis in Damascus, Syria, from 2008 to 2016http://cmm.mazums.ac.ir/browse.php?a_id=110&sid=1&slc_lang=en
<p><strong>Background and Purpose:</strong> It is important to follow annually the probable changes in distribution pattern of dermatophytosis and its etiological agents in different communities. In this study, we determined the prevalence of dermatophytosis and its causative agents in Damascus, Syria, between 2008 and 2016.</p>
<p><strong>Materials and Methods: </strong>A total of 4080 outpatients who visited the dermatological clinics in Damascus, were evaluated. The specimens were collected from clinically suspected tinea. The patients were referred to our laboratory for direct examination by 30<span dir="RTL"> %</span>KOH<span dir="RTL">.</span> Some of the specimens were cultured on Sabouraud Dextrose Agar for fungal identification.</p>
<p><strong>Results: </strong>Out of the 4080 cases, 1138 cases were positive in direct examination(%27.89) , including Tinea pedis (%46.98), followed by tinea capitis(%39.79) , tinea corporis (%25.38), toenail onychomycosi (%20.33), tinea manuum (%16.06), and fingernail onychomycosis .(%15.22) Tinea pedis and toenail onychomycosis were more common in summer %41.19) and %25.78 respectively .(<em>Trichophytic rubrum</em> was the most prevalent fungal pathogen, especially in toenail onychomycosis.</p>
<p><strong>Conclusion:</strong> Dermatophytosis is highly prevalent in Syria<span dir="RTL">. </span>This study provides valuable data for differential diagnosis of dermatophytosis</p>
Mohammad Taher IsmailOsteomyelitis and lung abscess due to Aspergillus fumigatus in a chronic granulomatous
disease patienthttp://cmm.mazums.ac.ir/browse.php?a_id=108&sid=1&slc_lang=en
<p><strong>Background and Purpose:</strong> Chronic granulomatous disease (CGD) is an inherited disorder of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. This disorder results in recurrent life-threatening bacterial and fungal infections. <em>Aspergillus </em>species are the most common fungal infections in these patients.</p>
<p><strong>Case Report: </strong>Herein, we present a case of fungal infection in a girl with CGD. We confirmed aspergillosis through the positive microscopic and macroscopic examinations, as well as radiology results. Invasive aspergillosis in this patient with pneumonia, lung abscess, and osteomyelitis of the ribs was not initially treated with amphotericin B (Am B) and recombinant interferon-gamma.</p>
<p><strong>Conclusion:</strong> Among infectious diseases<span dir="RTL">, </span>fungal infections<span dir="RTL">, </span>in particular aspergillosis<span dir="RTL">, </span>remain a serious problem in CGD patients. Considering poor clinical response and deficient immune system, rapid diagnosis of fungal infection and optimizing the treatment of these patients are recommended<span dir="RTL">.</span></p>
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Seyedeh Zohreh Jalali